Treatment of arthrosis of the knee joint with folk remedies: what, how and why?

Arthrosis is a degenerative-dystrophic disease of the joints, in which changes occur in the articular cartilage. Later, bone deformities also appear. The main manifestations of arthrosis are pain and limitation of movements in the affected joints.

You can find out about the causes, symptoms and diagnosis of arthrosis here or here.

In the treatment of arthrosis of the knee joints, medications occupy a leading place.

Based on tactical principles, all medications used for arthrosis of the knee joints can be divided into several groups:

general information

The knee joint regularly experiences enormous stress. Walking, running, jumping, climbing stairs and simply standing - all this has an impact on the condition of cartilage. The processes of destruction and restoration are in constant balance, but if, under the influence of certain reasons, this balance is disturbed, the gradual development of arthrosis begins.

Initially, microcracks appear in the thickness of the cartilage, which help reduce its thickness in some areas. As a result, the load is redistributed on the contacting surfaces of the bones, which accelerates the pathological process. Gradually, a whole complex of changes occurs in the knee:

• thinning of cartilage until complete disappearance;
• changes in the composition and reduction in the amount of synovial fluid;
• damage to bones due to friction against each other;
• the appearance of bone protrusions (osteophytes) first along the edges of the joint, and then throughout its entire area;
• compaction of the joint capsule as a result of a chronic inflammatory process, which leads to joint stiffness;
• compensatory spasm of surrounding muscles.

Ultimately, the knee becomes significantly deformed and mobility is limited, leading to disability.

Depending on the location of the process, arthrosis of the knee joint can be unilateral and affect the right or left knee, or bilateral. In this case, both legs are affected.

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Anatomical types of arthrosis

To correctly make a medical report, knowing which joint is affected by the disease is not enough. The classification of arthrosis also identifies specific types of disease.

Deforming arthrosis

Deforming arthrosis is otherwise called osteoarthrosis, where osteon in Greek means bone, i.e. The articular cartilage and the articulating surfaces of the bones underneath are affected by the disease, and then the destructive process involves the synovial membrane, ligaments, and spreads to the capsule and nearby tissues.

Deforming arthrosis

The disease is accompanied by bone growths (osteophytes), manifested by pain and limitation of movement in the joint. The subchondral layer of the bone dissolves (sclerosation), and at the same time, along the border of its surface, osteochondral growth begins with possible cyst-like bone cavities. Changes in bone tissue along with loss of cartilage alter the shape of the joint.

Exudate accumulates in the joint, disrupting the properties of the synovial fluid. The joint capsule, ligaments and muscles are destroyed. When the range of motion is limited, muscle atrophy occurs. At the very beginning of the development of deforming arthrosis, the pain is aching, but it intensifies with load and its duration increases. A characteristic crunching sound (crepitation) appears.

If the disease is not treated, stiffness of movement due to osteoarthritis leads to:

• deformation and enlargement of the joint;
• development of synovitis;
• fibrous ankylosis (immobility).

Uncovertebral arthrosis

This is a disease that destroys the vertebrae in the cervical region. First, the intervertebral cartilage is destroyed, then the discs and bone tissue. Growing bone tissue presses on nerve bundles and blood vessels, injuring muscle tissue. In addition to pain in the neck and when moving the head, patients suffer from headaches, and if left untreated, numbness and loss of sensation in the upper extremities.

Post-traumatic arthrosis

This is a disease that most often develops after injury, fracture, or gunshot wound. Conservative methods are aimed at preventing further joint deformation and relieving pain, but refer only to symptomatic care. They will only work if the disease is diagnosed at an early stage. In advanced stages, only surgical treatment will help restore joint mobility.

Degenerative arthrosis

In medicine, “degenerative” means a disease in which neurons die. When we talk about degenerative arthrosis, we mean osteoarthritis; this type is not included in the medical classification of arthrosis. The goals of treatment are pain relief, maintaining joint mobility, and optimizing joint function. For this purpose, drug treatment, physical therapy (physical therapy) and lifestyle changes are used. Prosthetics are prescribed as a last resort if previous methods have failed.

Rheumatoid arthrosis

Rheumatism is an autoimmune disease when the body considers its own cells to be the enemy. In this case, the connective tissue becomes inflamed, the disease spreads to the heart, joints, and internal organs. In rheumatoid arthrosis, secondary to arthritis, rheumatoid joint fever and inflammation of the cartilage with subsequent destruction are typical.

Psoriatic arthrosis

A secondary disease that develops against the background of psoriatic arthritis. The inflammatory process leads to a change in the composition and viscosity of the synovial fluid, cartilage tissue begins to break down, and then the bone. Treatment is aimed at blocking inflammation and restoring the joint.

Causes

Arthrosis occurs against the background of its damage due to increased load, inflammation, or against the background of congenital pathologies of the articular apparatus. The list of the most common reasons includes:

• knee injuries: dislocations, damage to ligaments and menisci, severe bruises accompanied by hemorrhage into the joint cavity, intra-articular bone fractures;
• increased load on the joint: professional sports, lifting weights, working in a standing position, wearing the wrong shoes, excess body weight;
• connective tissue pathologies: systemic lupus erythematosus, rheumatoid arthritis;
• congenital and acquired weakness of ligaments and muscles, including those associated with low physical activity;
• diseases or injuries of the musculoskeletal system, accompanied by increased load on the knee (flat feet, arthrosis of the hip joint, etc.);
• hormonal disorders, especially diabetes;
• metabolic disorders accompanied by salt deposition (gout);
• inflammation of the joint (arthritis) regardless of the cause;
• knee surgery;
• heredity.

“Difficult” client – ​​see a doctor!

Joint pain that persists for a long time or is accompanied by unusual symptoms is a reason to consult a doctor. There are alarming symptoms (“red flags”) that require special attention:

• redness in the joint area, swelling, increased temperature in the joint area, decreased range of motion;
• combination of acute arthralgia and fever;
• joint pain in combination with skin damage and signs of inflammation of adipose tissue;
• indications of a history of bleeding disorders or use of anticoagulants;
• the presence of extra-articular or systemic manifestations (weakness, weight loss, sweating);
• night pain, awakening due to pain;
• previous trips to tropical countries.

In each such case, therapy should be determined only by the attending physician.

Degrees

Depending on the extent of tissue damage, orthopedists distinguish 4 degrees (stages) of arthrosis of the knee joint, which determine its symptoms:

• grade 1: there are no symptoms, and minor abnormalities are found on x-rays;
• degree 2: the patient notes episodic pain during physical activity, when walking up stairs, squats, and standing for a long time; The images reveal a narrowing of the joint space and obvious foci of degeneration; initial manifestations of osteophytes or calcification of the lateral ligaments of the joint.
• degree 3: pain haunts the patient constantly, even at rest, walking without a cane is impossible; X-rays show a significant narrowing of the joint space, sometimes asymmetrical, due to damage to the menisci, signs of joint deformation, multiple, large osteophytes, bone growths;
• grade 4: movements in the joint are practically impossible, X-rays reveal complete destruction of cartilage and significant deformation of the articular surfaces of the bones, a large number of osteophytes; in severe cases, the bones fuse together.

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Andrey Sergeevich, some interesting facts about the knee joint.

The knee joint is one of the most complex joints in humans. Did you know, for example, that in fact there are not one, but three joints? Three in one! And each of these three can bother you, and often 2 or all 3 at once. Two of these three are the articulations between the condyles of the femur and tibia (on the inside and outside), the third is at the place where the kneecap (patella) slides along the front surface of the femur. Moreover, it is in this third joint that age-related changes can begin the earliest, causing pain and discomfort in the anterior sections, around the kneecap. The contacting surfaces of the bones are covered with cartilage - a “spray” several millimeters thick, externally smoothly polished for the smooth sliding of one bone over another. The elasticity of cartilage ensures its function as a shock absorber - when walking, all shocks are absorbed due to the elastic deformations of the cartilage. Have you ever driven in a car with a faulty shock absorber? Every small bump and hole feels like a big bump. Likewise, the human body - if the cartilage is worn out, “does not work” - all the shocks (how many steps do we take in a day?) are transmitted to the bone, to other joints, and even to the brain.

Let's talk more about pain in the knee joint. A common cause of knee pain, according to patients themselves, is “salt deposits.” What do you say about this?

We come to one of the main causes of knee pain – osteoarthritis. For the knee, this is called gonarthrosis. Popularly, this condition is often called “salt deposition.” But salt has absolutely nothing to do with it, since the basis of the disease is wear and tear of the cartilage. With age, everything in the human body wears out, including cartilage. Imagine how many sliding cycles our cartilage can withstand if for the first 30-40 years of life there are practically no signs of arthrosis. But over time, nature takes its toll. What if a person had injuries, the cartilage was damaged due to improper use of the knee joint? Excess weight is a direct destructive factor for the joint. That is why physical therapy for arthrosis is designed in such a way that the exercises are performed mostly on weight, without putting stress on the leg. We must not forget that movement is life. This fully applies to the knee joint - when moving, the cartilage is nourished. Scientists have proven that with osteoarthritis, in addition to mechanical wear and tear, inflammation is present in the joint, therefore the second name for this condition is osteoarthritis, and the main medications are drugs that reduce pain and inflammation. This inflammation is not so “malignant”, so pain with gonarthrosis is usually mechanical, i.e. associated with movements - walking, going up and down stairs, squats. These pains most often do not interfere with sleep. In order to make a diagnosis of osteoarthritis of the knee joints, ordinary x-rays, which can be taken at any clinic, are sufficient. You should not start diagnostics with “fashionable” MRI and ultrasound.

But today it is possible to restore damaged cartilage with medications?

The fact that medications restore cartilage is the second myth. It would seem that in order to defeat osteoarthritis, you need to restore damaged cartilage - that’s all. But how to do that? There are a lot of advertisements on TV and on the Internet for drugs that restore cartilage. A lot of dietary supplements are also produced, on which, by the way, it is directly written: “Not a medicine.” If the patient tolerates these drugs well, we most often turn a blind eye to their insufficiently proven effect. And side effects, unfortunately, also occur. The essence of all these drugs and supplements is that they contain cartilage components, most often chondroitin and glucosamine. However, if you imagine that every day the cartilage in the joint loses at least some molecules, then it turns out that medications must be taken every day for life. Will they be absorbed? And what part of that dose will reach the sore knee? Current guidelines for the treatment of osteoarthritis, issued by the American Academy of Orthopedic Surgeons, emphasize that the effect of these drugs remains unproven. Taking into account the long courses of taking them and the considerable cost, it is worth thinking about whether it is worth taking them at all? Apparently, you need to have a lot of faith in them.

What about hyaluronic acid? Its benefits have also not been proven?

Hyaluronic acid is popular today not only among cosmetologists, as it is an important component of cartilage. Hyaluronate is a matrix for the formation of cartilage, protects its surface layer, and in some cases reduces inflammation in the joint. Today the market is rich in drugs for injection directly into the joint. Because of their gel-like consistency, they are often called “lubricant,” and inserting them into a joint is compared to changing the oil in a motor. The price of hyaluronic acid injections is high, but side effects are rare. These injections work only inside the joint, without entering the bloodstream, so they can be administered to several joints at the same time. Such drugs most often alleviate the suffering of patients, but I would like to see more research on their effectiveness. Keep in mind that these are not painkillers; they will not give quick results, but will help preserve the joint for some time. It is important to understand that with extreme wear of the joint, no “lubricant” will help, even in triple doses, because it is not a panacea. Well, don’t forget that any intervention in the joint can lead to complications, most often this is the entry of microbes into the joint, albeit with minimal probability.

Can stem cells be used to repair damaged cartilage?

The belief that stem cells can cure any disease is also a myth. Scientists around the world and in our country are conducting research on the use of stem cells to restore cartilage. These works are very promising and will eventually become operational. But it is important to understand what is possible and what is not. No amount of stem cells will reverse the development of osteoarthritis. Today, this is only one of the methods for eliminating focal ones, i.e. Small damage to the cartilage, which usually occurs after injury, is sufficient. But when the cartilage is worn out in all parts of the joint, then, alas, there is no need to expect a miracle. By the way, the use of blood cells to restore cartilage has been used for a long time. True, these methods help to grow fibrous, scar-like cartilage instead of real articular cartilage (hyaline). It's not exactly like hyaline, but it still slows down the destruction of the joint. Stem cells are capable of forming hyaline cartilage. Whether miracles still happen, I hope we will find out in the near future.

“Osteoarthritis is for the elderly” – is it a myth or reality?

Unfortunately, it's a myth. The frantic pace of life in the 21st century, the passion of young people for active recreation, the popularization of sports, motorization - all this leads to an increase in injuries that do not spare the knee joints. The development of medicine at the present stage allows us to discern osteoarthritis in the early stages, and if necessary, then look into the joint with “little blood”. Most likely, you have heard the word “meniscus”; someone in the emergency room was diagnosed with “ligament damage” or at least “bruise”. All this, one way or another, leads to increased wear of the cartilage. A common problem for athletes involved in football, handball, alpine skiing, and martial arts is damage to the anterior (less often, posterior) cruciate ligament. Instability and instability arise in the joint, and muscle-joint sense is lost (a beautiful word is proprioception). Subluxations constantly occur in the joint, sharply increasing the wear of the cartilage. Without surgery, it is most often impossible to restore full function of the joint. Unfortunately, the diagnosis is often not made in time, despite obvious symptoms. Surgeries to restore cruciate ligaments require long-term rehabilitation, hard work by a surgeon and then a rehabilitation specialist, otherwise the effect will be incomplete. In our country, such operations have been practiced, and the results are no worse than in leading foreign clinics. Another reason for the development of osteoarthritis in young people is a disease of unknown origin called osteochondritis dissecans (in the form of Koenig's disease). These words hide the death of a piece of bone with cartilage covering it, which is why this fragment “falls off” over time and begins to move freely around the joint (such a piece is also called a “joint mouse”), pushing through the cartilage and leading to jamming of the joint. In this case, you cannot do without surgery. More often, the joint can jam when the menisci are damaged, when it is not difficult to bend the knee, but it is not possible to straighten it completely. The meniscus is a cartilage that is located in the form of an additional pad between the articular ends of the thigh and tibia in the knee joint and, if damaged, can cause a “blockade” of the joint. If you try to forcibly remove such a blockade (for example, under anesthesia), this can aggravate the meniscus tear or damage the cartilage around it, so surgery is usually necessary. Nowadays, such interventions are performed through two small incisions, and the image from the knee is displayed on the screen of a large monitor, which makes it possible to look into all corners of the joint. In any case, not a single knee injury (and surgery is also a kind of injury) does not leave a mark on the joint. We must not forget about this.

When the cartilage is completely worn away, you can install an artificial joint; will this completely cure osteoarthritis?

Unfortunately, osteoarthritis itself is incurable. All ways to escape from it - painkillers, physiotherapy, ointments, compresses, therapeutic exercises, reducing stress and body weight, chondroprotectors - have their limits. After all, the strength of cartilage is also genetically determined: someone at 80 years old can walk without a cane, and someone already limps at 60 years old. So, sooner or later, a situation may arise when nothing helps, you have to take painkillers every day, pain prevents you from sleeping at night, and you can only feel nostalgic about an active lifestyle. The leg bends poorly at the joint and does not fully straighten, it is twisted, the muscles have atrophied, it is impossible to walk without a cane... It sounds pessimistic. But it is precisely in such cases that the knee joint has been replaced with an artificial one for many years all over the world. This operation allows you to cope with the above complaints, although it imposes certain restrictions on the patient. Sounds optimistic now. Of course, any operation is a risk for the body. By implanting an artificial joint, we are not treating arthrosis, but in fact we are simply replacing “our” joint with a “foreign” one. People often ask: how long does a prosthesis last? No one will give you an answer, because there is always the possibility of complications. Sometimes knee pain can persist even after a prosthesis is installed. It is clear that it is best to extend the service life of your “native” joint as much as possible, without bringing the matter to endoprosthetics. But we tend to put off going to the doctor until the last minute. And then, during the first visit, it suddenly turns out that the knee joint is already so destroyed that there is simply no escape from the operation. In our country, a lot of such operations are performed, and passport age is not a hindrance; if a person has looked after his health throughout his life, then at 70 or 80 years old he will be able to undergo such an operation.

Is a clicking sound in a joint a warning sign?

Let’s say right away that there are two types of clicks in the joint. The first one is with pain, the second one is without pain. For some reason, patients are more likely to worry about painless clicks and crunches than painful ones. Clicking without pain is usually physiological, that is, “normal.” You've probably heard that there is fluid in the joint, a lubricant. It reduces friction and facilitates movement in the joint. There is never enough of it, although some people think that their joint is “dry” and that’s why it crunches. Normally, there is negative pressure inside the joint, and with some movements, the layers of lubricant covering the articular surfaces stick together and come apart, which gives a characteristic click. But this is not the only reason for painless clicks. By the way, a number of weather-sensitive people begin to “twist their joints” due to the weather, which is associated with a drop in atmospheric pressure and a relative increase in intra-articular pressure, which temporarily becomes positive. In the same way, with inflammation, which is called synovitis, there is a lot of fluid, the joint swells, and it is difficult to move, especially to bend. In this case, an enlargement of the joint upwards from the kneecap, visible to the eye, occurs. Synovitis is often very, very difficult to treat. Let's get back to the crunch. And he can be loud! Most often, especially in young people, it occurs due to friction between the kneecap and the thigh when sliding (remember “three joints in one”?) and can be a harbinger of initial, incipient changes in the so-called patellofemoral joint. However, such a painless crunch in itself only requires increased attention to your knee joints. When clicking with pain, the reasons that cause it are dangerous. For example, when a meniscus ruptures, its flaps erase the cartilage. In a small number of people, the external meniscus has congenital shape features that can lead to damage even without much trauma (“discoid” meniscus). Painful clicking sounds also accompany osteoarthritis. It happens that clicking occurs due to the presence of bridges, septa, folds inside the joint, usually congenital, which may require surgery. So, let's go to the doctor less often for trifles and be sure to go to the doctor not for trifles.

If it hurts under your knee, is it a cyst?

On the educational Internet pages where our patients like to look, it is written that if there is pain behind the knee, then it is a Baker’s cyst (named after the doctor who once described it). What it is? Behind the knee are muscle tendons that slide back and forth in their sheaths. There is also its own lubricant, like the one in the joint itself, but only a thin layer of it. For certain or uncertain reasons, a channel is formed between the joint and these cases. Fluid flows from the knee into the tendon sheath, swelling it, and a cyst is formed - a bag of viscous fluid. The size of the cyst may not always be constant: sometimes larger, sometimes smaller. For those who consider a cyst to be a manifestation of arthrosis, I will tell you that it occurs in children of school and even preschool age, where arthrosis is not discussed in principle. The cyst is most often small and does not cause discomfort. If it is large enough and visible to the eye, we can recommend its removal. Large, tense cysts can sometimes put pressure on nerves and blood vessels, and with sudden movement they can burst, leading to a chemical burn to the tissues of the lower leg. Cyst and cyst are different. For example, parameniscal cysts (“near the meniscus”) may be located around the knee - when the meniscus ruptures, the membrane of the joint is damaged and fluid flows beyond its limits, forming a tense “hernia” of various sizes. Such cysts do not go away without surgery. And yet, when there is pain under the knee, cysts are often not detected. Usually the pain is caused by a spasm of muscle fibers in this area against the background of gonarthrosis or osteochondrosis of the spine, when the pain radiates along the nerve roots and trunks of the lower back. In younger patients, pain in the posterior parts of the joint accompanies damage to the posterior parts of the menisci or damage to the anterior cruciate ligament, when the popliteal muscles partially take over its function and become overworked.

Andrey Sergeevich, if your knee hurts, then that’s what you need to treat?

For many patients who come in complaining of knee pain, it comes as a surprise that the knee joint, when thoroughly examined, turns out to be not so bad. It seems like you should be happy, but it hurts! And there seems to be no arthrosis, and the cartilage is fine, and the menisci and ligaments are intact, and there is no inflammation either. But there may be other causes of pain. The rule of orthopedics: “If the knee joint hurts, examine the hip joint.” Yes, with coxarthrosis (the so-called osteoarthritis of the hip joint) or inflammation of the hip joint, pain can radiate (radiate) to the knee, and often. If the hip joint itself does not bother you so much, this can lead to diagnostic errors and force you to look for a problem in the knee, that is, where there is none. Although it was enough to just take a step to the side. Another common cause is problems in the back, such as a herniated disc between the lumbar vertebrae, which causes nerve compression. But we know that it is the nerves that are responsible for transmitting pain. In rare cases, patients may experience such pain due to gynecological problems with pelvic inflammation, because the sciatic nerve passes very close. Finally, a surprisingly common cause of knee pain is compression of the sensory nerve between the thigh muscles. This is very common, but for some reason it is rarely diagnosed. When a patient complains of pain in the inner half of the knee, which bothers day and night, has a burning character (“the knee feels like it’s been poured with boiling water”), reacts poorly to painkillers, sometimes radiates under the knee or into the shin - this is most likely just such a condition , which, unfortunately, is very difficult to treat. But if the pain can be stopped, then the patient’s happiness knows no bounds! This is exactly the case when the disease can be eliminated and the patient can be cured. Do not forget about the so-called systemic diseases - gout, rheumatoid arthritis, psoriasis, ankylosing spondylitis. In these cases, an inflammatory process occurs in the knee joints; they hurt both during movement and at rest, during the day and especially at night. In these cases, the pain is not due to injury or wear and tear on the joint, but the inflammation itself leads to rapid destruction of the cartilage. Infections of the genitourinary tract, which patients usually modestly keep silent about, cause reactive arthritis with the same manifestations, and often consequences. So there is no need to hide your concomitant illnesses from your doctor.

Andrey Sergeevich, what should people with pain in the knee joint and those who do not complain about this pain remember?

The knee joint is complex, and there are many causes of pain in it. It is very difficult to cover all diseases of the knee joint in our conversation. Take care of your joints, avoid injuries, excess weight, and see a doctor from time to time. Do not self-medicate, consult professionals. Remember that medications and surgeries do not always help. Be healthy!

Symptoms

Symptoms of knee arthrosis are typical of a degenerative lesion. A person faces the following problems:

• pain at the initial stage manifests itself in the form of mild discomfort after climbing stairs, and then gradually increases; with severe damage, it becomes permanent and torments the patient even at rest;
• morning stiffness: occurs already in the early stages of development, at first lasts only a few minutes, then up to half an hour;
• crunching: occurs with the second and further degrees of damage, differs from physiological sound in sharpness and special tonality, and is also accompanied by pain;
• limited mobility: associated with the proliferation of osteophytes and increased bone friction; bending and straightening the knee is difficult and often accompanied by pain; in the final stages, the joint may become completely blocked (ankylosis);
• knee deformation: occurs due to changes in the shape of the contacting bones, bone growths and involvement of muscles and ligaments in the pathological process; when inflammation occurs, swelling of the tissues around the joint occurs;
• lameness: as arthrosis progresses, a person lame more and more; in the later stages, he is forced to use a cane or walker.

Diagnostics

Diagnosis of arthrosis of the knee joint is carried out by an orthopedist-traumatologist. The following help to distinguish the disease from pathologies with a similar picture, as well as determine the degree of damage:

• interview and history taking: the doctor finds out the main complaints, the history of the development of the disease, learns about previous injuries, etc.;
• examination: the degree of knee mobility, tissue deformation, and pain syndrome characteristics are revealed;
• laboratory diagnostics: a general blood test reveals inflammation, a biochemical test reveals possible causes of problems;
• X-ray methods: X-ray and CT are the main diagnostic methods, allowing to detect typical signs of arthrosis: narrowing of the joint space, osteophytes, bone deformations;
• MRI: makes it possible to visualize soft tissues, assess the condition of muscles and ligaments;
• Ultrasound: assessment of the condition of muscles, tendons, joint capsule;
• joint puncture: allows you to take an analysis of the joint fluid, as well as insert a miniature camera to examine the cavity from the inside (arthroscopy).

If necessary, additional studies and consultations with specialists are prescribed.

Treatment of arthrosis of the knee joint

All treatment methods for arthrosis of the knee joint can be divided into three groups:

• medicinal;
• physiotherapy;
• surgical.

When a patient is diagnosed with stage 1-2 disease, a complex of medications and physical therapy is used, but if the lesion has become extensive, surgery remains the priority.

Drug treatment

Proper administration of medications can relieve pain, stop the inflammatory process if it exists, and also stop or at least slow down the destruction of cartilage tissue. The following groups of tools are used for this:

• anti-inflammatory (ibuprofen, ketoprofen, diclofenac, as well as their derivatives): relieve inflammation and relieve pain in the joint;
• hormonal (corticosteroids): prescribed when anti-inflammatory drugs are ineffective;
• antispasmodics (mydocalm and analogues): help get rid of muscle spasms and alleviate the patient’s condition;
• chondroprotectors (glucosamine, chondroitin and their combinations) stimulate the processes of regeneration of cartilage tissue;
• drugs to improve microcirculation (nicotinic acid, cinnarizine, pentoxifylline): improve the supply of oxygen and nutrients to the joint.

Depending on the situation, tablet, injection and local forms of drugs are used, intra-articular administration is allowed. Only a doctor is responsible for selecting medications, their dosage and frequency of administration. If used uncontrolled, many drugs can worsen the condition of the joint and also cause unpleasant side effects.

Physiotherapy

Physiotherapeutic techniques are used to improve blood circulation in the joint area, increase mobility, and also enhance the effect of medications. The doctor may prescribe:

• shock wave therapy: ultrasound of a special frequency, helps eliminate osteophytes;
• magnetotherapy: exposure to a magnetic field, stimulating metabolism and regeneration processes;
• laser therapy: deep heating of tissues with a laser beam;
• electrotherapy (myostimulation): exposure of muscles to a weak electric current;
• electro- or phonophoresis: administration of medications (chondroprotectors or analgesics) using electric current or ultrasound;
• ozone therapy: introduction of a mixture of gases into the joint cavity.

Physiotherapy exercises and massage are also prescribed according to individual indications.

Drug therapy

The use of drugs remains one of the main methods of treatment. At the moment, there are no medications that are guaranteed to restore cartilage or at least prevent its further destruction. However, a number of medications can achieve good results by enhancing regenerative processes, reducing inflammation, and protecting cartilage from strong mechanical influences.

The drugs can be used in the following ways:

• applied internally;
• administered intramuscularly or intravenously;
• applied to the skin above the knee joint;
• are injected into the joint.

Since in most cases there is a gradual destruction of the cartilage of the knee joint, treatment is carried out in tablet forms of drugs. They are more convenient to use and do not require the constant participation of medical personnel in the treatment process.

Intra-articular injections are also often used. They are good because they allow you to get a stable, long-term result after several injections of medication. It lasts for six months or a year. The use of injections in the knee can reduce the need for medications that are administered orally. Accordingly, the medication burden and the risk of side effects are reduced.

Creams and gels are auxiliary treatments. It is purely symptomatic. Used to reduce pain and eliminate swelling. There are no topical medications that can restore knee articular cartilage or even slow down its degeneration.

Surgery

Surgical treatment of knee arthrosis is prescribed when other methods are ineffective. Doctors perform several types of operations:

• endoprosthetics: complete replacement of a damaged joint with a prosthesis;
• arthrodesis: fastening bones together to eliminate mobility (reduces pain and allows a person to lean on the leg);
• osteotomy: cutting one of the bones and placing it at the optimal angle to reduce the load on the joint.

Arthrodesis and osteotomy are used when it is impossible to perform endoprosthetics or it is necessary to postpone this operation for some time.

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Prevention

To keep your knees healthy, you must adhere to the following rules:

• lead an active lifestyle, engage in amateur sports, walk more and do exercises;
• avoid stress and overwork;
• minimize the risk of injury;
• maintain weight within normal limits;
• eat properly and balanced;
• wear high-quality orthopedic shoes;
• Avoid putting excessive stress on your knees (heavy lifting, professional sports, prolonged work on your feet).

The same rules are relevant for those who already suffer from arthrosis, because following them helps slow down the development of the disease.

Diet

The condition of cartilage largely depends on the quality of nutrition. If there are signs of arthrosis, it is recommended to exclude:

• carbonated drinks;
• alcohol;
• excessively fatty and spicy foods;
• canned food and semi-finished products;
• products with artificial colors, preservatives, flavors.

The diet should contain a sufficient amount of protein, fatty acids (especially omega-3), collagen (found in gelatin, agar-agar). It is necessary to structure the menu in such a way as to prevent weight gain.

Nutrition for gonarthrosis

First of all, doctors advise excluding red meats and offal such as liver from the diet. Priority should be given to fruits and vegetables, cereals with a high content of gluten and fiber, without salt and sugar. As well as fermented milk products, fish and nuts.

The last time you eat food should be no later than 19:00. The frequency of food intake can remain familiar, as it has developed over many years. But it’s better to eat in fractions – in small portions 5-6 times a day in the morning.

Breakfast should be the most plentiful - it sets the body in the mood for work and maintains strength until lunch.

If, especially at first, the feeling of hunger becomes unbearable, trick your stomach - eat an apple or chew a carrot. Just don't eat high-calorie bananas and grapes!

Don't give up jellied meats. Carrying collagen to the body and joints - the raw material for the construction of cartilage tissue.

Drink at least 2 liters of liquid per day: water and/or natural juices.

Eliminate from your diet:

• Red meat;
• Lard, smoked meats of any kind;
• Everything is spicy;
• Semi-finished products of unknown origin;
• Carbonated drinks with sugar;
• Vegetables: white cabbage, tomatoes, red bell peppers.

Potatoes because they are high in calories (carbohydrates!) and help you gain excess weight. Therefore, the Dukan diet will be relevant.

Consequences and complications

Osteoarthritis of the knee joints develops very slowly, but if left untreated, this disease becomes the cause of serious and unpleasant complications:

• severe deformation of the joint and leg in general (associated with changes in the configuration of the knee, as well as restructuring of the muscle frame and curvature of the bones);
• shortening of the limb by grinding down the heads of the bones;
• ankylosis: complete lack of movement in the affected knee;
• damage to other parts of the musculoskeletal system due to improper load distribution (heel spur, arthrosis of the hip joint, pain in the spine).

To prevent these problems, it is important to undergo a timely examination by an orthopedist and follow his recommendations. Self-medication and addiction to folk remedies can cause a serious aggravation of the situation.

Types of spinal arthrosis

Arthrosis also affects the facet joints of the spine, formed by the 2 lower ones of one and the 2 upper ones of the other. The second name for such an articulation is zygopophyseal. The articular surface is tiny, approximately 2 cm in diameter. There is shock absorber cartilage between the processes; the outside of the joint is protected by a capsule. Synovial fluid is produced by the synovial membrane.

Main reasons:

• developmental anomalies and injuries of the spinal column;
• diseases affecting the vertebrae (autoimmune diseases, spondylitis, osteochondrosis, etc.);
• high loads on the spine (sports, physical labor);
• lack of vitamins, minerals and hormonal imbalance;
• infectious diseases.

Arthrosis of the cervical spine

Pain and crunching when bending and turning the neck do not indicate arthrosis. Just like they don’t say weakened vision and hearing, impaired coordination, loss of sensation in the hands. However, all these symptoms, together with a limitation in the range of motion, are a reason to consult a doctor and undergo treatment.

Arthrosis of the thoracic spine

The main symptoms of arthrosis of the thoracic region, including costovertebral joints):

• labored breathing;
• chest stiffness (difficulty breathing, expansion of the lower lungs when inhaling is painful);
• pain.

The pain may be cardiac, difficulty breathing is associated with pulmonary-cardiac insufficiency. Be sure to consult your doctor.

Arthrosis of the spine

Main symptoms:

• pain in the lumbosacral region, aggravated by movement;
• stiffness (painful twisting and bending);
• occasionally numbness and weakness in the legs.

It may not be arthrosis, but a pinched sciatic nerve or hernia. The correct diagnosis will be determined by the doctor after examination.

Arthrosis of the coccyx

The causes of arthrosis of the coccyx are all diseases that lead to poor circulation in the pelvis, infectious diseases, and spinal injuries.

Arthrosis of the sacrococcygeal joint can lead to exacerbation of gynecological and urological problems. Local redness, pain, swelling, local fever are symptoms related to various diseases. However, if there is a decrease in mobility when bending and moving (it seems that a board is tied to the patient’s back), this is a reason to consult a doctor.

Treatment at the Energy of Health clinic

If your knee begins to crackle or ache suspiciously after physical activity, you should immediately make an appointment with an orthopedist. The Health Energy Clinic offers its patients the most popular and effective methods for treating the early stages of arthrosis:

• modern drug regimens for cartilage restoration and pain reduction;
• intra-articular administration of drugs for rapid pain relief;
• physiotherapeutic techniques;
• physical therapy under the supervision of an experienced instructor;
• professional massage;
• PRP therapy;
• injection of artificial synovial fluid to facilitate movement.

All methods of treatment and prevention are selected individually depending on the results of the examination.

Glucocorticosteroids

If NSAIDs are insufficiently effective, as well as with synovitis, intra-articular administration of corticosteroid drugs is recommended -

Diprospan

Kenalog

Their administration quickly relieves pain and inflammation, but given that these drugs are hormones, their use is limited. It is believed that no more than 5 intra-articular injections are permissible with an interval of at least 5 days between them, after which it is necessary to refrain from administering them for several months in order to avoid the development of side hormonal effects and adrenal insufficiency.

Advantages of the clinic

The Energy of Health clinic has modern equipment for diagnosing and treating a wide variety of diseases. We offer each client:

• comprehensive screening programs to identify various diseases;
• effective methods of laboratory and instrumental diagnostics;
• modern approaches to the treatment of diseases, including not only medications, but also physiotherapy, exercise therapy, massage and diet according to indications;
• consultations of highly qualified specialists;
• flawless performance of medical procedures;
• comfortable conditions and maximum comfort within the walls of the clinic;
• reasonable prices for all services.

Health is the greatest value. We will help restore and strengthen it. Take the first step towards excellent health, sign up for an examination at Health Energy!